HomeMy WebLinkAbout0047542-Electric (service change)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
~3Y
N!-47542
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PLAN NO.
ADDRESS
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Class of Const,
Height
Occupancy Permit
Foundation
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
"
ELECTRIC CONTRACTORd/-<~
Electric Servo New 0 Change~ Temp 0 Type'?d-volt~W AmpsLJi)
Fixtures ~. --SWitches ( ---- Receptacles ~ Circuits ({--
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _OW _OF _ San. Sewer
_WC _FOr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
FEES: Valuation $ If 2. ~. 0--0
ISSUED BY ~ ))....--
Permit Fee Paid $
Date
/
/
.$l). b '" /'
f 0/ S/7 ~.....-
.
Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
PERMIT NO. l.f 7 '.><f V
ELEC. CO~TR.. UJ~
OWNER
. APPL. DATE
!
~
J/C~
VOL S
RECEPT 'S'
TEMP .
AMPS .
CIRC ' 's
'.)\nDRESS L- "5 If
NATURE OF WORK
~C. SERVo NEW
DESC. TYPE
FIX'S SW'S
APPLIANCES
SI"GNS
INSP. ROUGH N
EST. COST t '2-". () v
REMARKS
FINAL
DATE PD